The thousands of youngsters watching the Lord Mayor’s Show are living proof
that London is rather healthier today than when the show was first held in
the 16th century.

Last Saturday’s Lord Mayor’s Show continued a tradition that began in 1535 and through fire, flood, and tents has not missed a single year since (although in 2011 its leader had to go to the side, rather than the main, door of St Paul’s). It is less extravagant than once it was (no “negroes riding on panthers”) but the parade was spectacular and the thousands of children on the pavements seemed to enjoy it.

Things have changed. Although the present Mayor was no more democratically elected than was the first, in 1189, he now has no real power. Some of his predecessors were less than effective in wielding what was once impressive authority. In 1666, Sir Thomas Bludworth said on first seeing the Great Fire, “Pish, a woman could p--- it out” and after failing to persuade people to pull down houses as a firebreak cried to Pepys, “Lord! what can I do? I am spent,” and went home to bed.

In that eventful century, a John Graunt was teasing out London’s patterns of birth and death. He devoured the records of burials and baptisms to make the world’s first “life table”.

From 1629 every funeral had been marked with a cause of demise. They included ague (malaria), apoplexy (stroke), chrisom (infant death after baptism), frighted (heart attack), overlaid (an infant smothered), strangury (kidney disease), rising of the lights (croup), together with one unfortunate “bit with a mad dog” and another who perished of piles.

Apart from the dog and perhaps the piles, each agent tended to attack those of a particular age. They could hence be used to work out the chances of survival at various stages of life.

Many “died of the thrush, convulsion, rickets, teeth, and worms, or as abortives, chrisoms, infants, liver-grown, and overlaid that is to say, that about ½ of the whole died of those diseases which we guess did all light upon children under four or five years old”. Graunt estimated that about one child in three met its end before the age of six and that only a single new-born in 30 made it to three score and 10. London was a dangerous place, for children most of all; and many died long before they had the chance to see the Show.

Occasional epidemics made things worse. Graunt recorded that in 1665 seven out of every 10 burials were from the Black Death (Pepys: “…sad the story of the plague in the City, it growing mightily”), which in previous decades was almost unknown. The Lord Mayor’s response was to order the destruction of all the city’s cats and dogs (which was unfortunate as they might have killed the rats that carried the fleas that passed on the infection).

The Plague Year was the bacterium’s last great visit of many. In 1350 there had been a huge attack. The Mayor, Richard de Kislingbury, ordered that two pits be dug, at East and West Smithfield. Within two years, more than a third of the City’s residents succumbed. Thousands were buried in the new cemeteries. People died within days, or even hours, of the first symptoms, memorably described as: “seething, terrible, wherever it may come, a head that gives pain and causes a loud cry, a burden carried under the arms, an angry knob, a white lump”.

A new comparison of the DNA from their skeletons, dug up from below the Royal Mint, with that of several modern strains of the bacterium hints that this infection was close to the root of today’s evolutionary tree, and may have been almost the first incursion of the plague into the human race.

As London became the biggest city in the world, children had an even worse time. Infant mortality between the 16th and the 18th centuries doubled (perhaps because virulent new strains of diseases such as smallpox arrived as trade increased). Then it fell sharply. Two out of three expired before they were five in the 1750s and no more than half that a century later.

Now things have changed again. Infant mortality – the loss of those less than 12 months old – has dropped to around one in 200 (many among them victims of inborn disease), a fortieth of what it was a century ago, when diarrhoea caused by contaminated milk or water was still a scourge. For those under five, the British death rate is down to 6.5 in every 1,000 live births, which is impressive but remains above the European average. Today’s Lord Mayor’s Show has a larger, happier and healthier audience than it has ever had.

Or, as the old faux-Cockney ditty has it, “Fings ain’t wot they used t’be”; to which the only response is: Thank God and the sewage authorities (only one of which has powers exercised through the Mayor).